pcl1029
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Hi, Amir,
glad to know your dad is fine.
I will wait until the completion of the chemotherapy and let see what the doctor will decide before getting worry.I agree Iranian people, like the American people, are of good nature and friendly; somehow the politics of the world get into the middle of our good human nature and act otherwise.
I hope one day I can meet you and the beautiful”eyelashes” together in Iran and have a glass of Coke-Cola,singing their famous commercial song of “I like to sing to the world of the perfect harmony….”
Good luck and
God bless.Hi, everyone,
I have revised the”systemic treatment for CCA” by adding or revising #18,#22 and #23.
and Near the top of the message ,I add three links to 3 of the articles about the newer anti PD-1 immunotherapy for solid tumors.God bless.
Hi,
This is definitely the best news recently I am aware of such a large grant for ICCA for research.
Thanks and
God bloess.Hi,
Another recent link for radioembo. if interested.
But they did not tell us the “may be risk factors “of prior to or after chemotherapy and radiation treatment.http://www.ncbi.nlm.nih.gov/pubmed/23602420
God bless.
Hi,
http://www.ncbi.nlm.nih.gov/pubmed/22956045
also read upon the related messages on radioembolizations on this forum under Radiation Tx and Options) start from early to most recent comments ,and you will arrive some sense of whether this treatment will work for your father.
It still a very debatable procedure. The efficacy vs the unknown side effects AFTER patient exposed to prior or afterward chemotherapy and different forms of radiation treatment to the liver ,morbidity and the current health situation of the patient.
For myself, It is a tough decision to be made base on a lot of variables.Others may disagree or simply have no alternative choice.God bless.
IN ADDITION TO THE ABOVE
“21. EGFR/VEGF ( panitumumab+ bevacizumab ; erlotinib+ bevacizumab. And Sorafenib + Erlotinib )
A recent case report of dual therapy with panitumumab and bevacizumab in a patient with widely metastatic GBC unfit for any cytotoxic therapy demonstrated a significant PR and improvement in performance status for 7 months (Riley and Carloss, 2011). A phase II study of 49 evaluable patients with chemotherapy-naïve aBTC investigated EGFR/VEGF inhibition with erlotinib and bevacizumab (Lubner et al., 2010). Six confirmed PRs were noted with a median duration of response being 8.4 months in those patients. Overall mTTP was 4.4 months and mOS was 9.9 months. Exploratory analysis of EGFR mutational status showed that those with EGFR truncation variant III or those with KRAS mutation suggested a less likely response to erlotinib; serum VEGF expression was not noted to change from baseline between responders and nonresponders. Recently, the SWOG 0941 trial enrolled 30 evaluable patients to receive first-line therapy with daily sorafenib and erlotinib with primary endpoint to improve PFS from 4 to 8 months (El-Khoueiry et al., 2012b). Two patients had a PR and 8 had SD as their best response, but there were 3 deaths while on study with one possibly related to treatment. The mPFS/OS was 2 and 6 months and the trial was stopped early due to a weak efficacy signal. Further studies are required to assess whether there may be benefit in certain subsets of patients.
God bless.http://www.cholangiocarcinoma.org/punbb/viewtopic.php?pid=57198#p57198Hi,Holly,
How are you?
”11.Erlotinib+bevacizumab regimen:(pt pop=53,43 had CCA the rest were gallbaladder);9 had partial response and 51 patients had stable responses.
grade 3-4 cerebral thrombosis or low blood flow(ischemia)and rash.’the above is from
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?pid=57198#p57198.
You can look over each drug and combine them to know more about their effcacy and adverse reactions.
One Caution: if you have diverticulitis ,and related colon problems,then make sure talk to your oncologist;each drug has the same side effect but combine together, the risk should not be take it lightly. My sis-in-law who passed away had just one – three doses of Avastin at the most, and she perforated her colon.
God Bless.Hi,Heather,
May be the best way to handle this is to wait a couple days,and go to the medical records dept, to get the surgical report to truly understand what is it all about with regard to the doctor ‘s comment.
That way you can know exactly what the doctor means and what is the ” damage “means . After that, then to see whether RFA,IRE,CRYOABLATION, and TACE , radioembo will be useful.
God bless.Hi,
Thanks Gavin for the info.
Rebecca ,if your father in law has liver metastasizes, I will get a 2nd opinion from the liver surgeon and also from an interventional radiologist to see whether the tumors can be removed first ,then will talk with the medical oncologist for adjuvant chemotherapy or targeted therapy. MASS GENERAL,JOHN HOPKINS SLOAN-Kettering are great hospitals just to name a few near you.First line chemo therapy include. GEM/CIS, GEMOX, 5FU/CIS,FOLFOX among others, second line including GTX,TARCEVA+Avastin, Sorafinib ,Rituximab etc.
Below is a link about systemic chemotherapy and targeted therapy in general, so you can have some ideas.
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=7843
Clinical trials are worth it depends on each individual case and the availablity and suitability to the patient, it is best to ask referral from your current oncologist if he/she opens to the idea.
Please check out the clinical trials on our web site under the cholangiocarcinoma on the top , open and click clinical trials and you will have some idea whether your father can go .God bless.
Hi, everyone,
Thanks,
Below is an article talking about the timing of PET scan after RFA ( the same apply to microwave ablation) to check on the ablation result whether is successful or not. For practical purpose, just read the last paragraph will be enough.http://jnm.snmjournals.org/content/47/8/1235.full
Below is how the lymph flows through the lymph node. The size of a normal abdominal lymph node ( not swelling) can be 2mm to 20 mm in length and can be as long as 10 mm in width .
Below is an other article about different types of lymph nodes; read page 841 and page 842 ,table 1 and 2 , and figure 18 that is more related to the regional lymph nodes in liver cancer to increase the understanding how lymph node diagnosis in relationship with its size and scan results .
http://bjr.birjournals.org/content/80/958/841.full.pdf
God bless.
Hi, Carl ,
for entertaining purpose, I used my old balance for making special formulation medications in the good old days and based on figure 8 of the study,the lowest dose of CUM using 1000mg/kg of body weight and thru subcutaneous route
(the first link); I hand measured using the balance to measure out how many grams actually it is equal to the curry powder that i used for cooking.The answer of course is depending on the dryness and the actual content of the active ingredient turmeric in the curry power.
The answer for my kind of curry power by oral route is equal to 10.75 tablespoonful(15ml=1 tablespoonful) or 75gm will be equal to the suggestion for the low end of curcumin dose of 1000mg/kg. That is a lot of curry power for cooking one or two dish for dinner.
I also find some interesting reading(see below); and if it is true, then we can add black pepper power to enhance the bio availability of turmeric.“Curcumin is the yellow pigment associated with the curry spice, Turmeric, and to a lesser extent Ginger. It is a small molecule that is the prototypical ‘curcuminoid’, and has effects similar to other polyphenols but unique in a way as it is a different class of polyphenol (relative to the other classes of ‘flavonoid’, ‘stilbene’, etc.)
It exerts potent anti-inflammatory effects, and these anti-inflammatory effects seem to be quite protective against some form of cancer progression. However, curcumin has additional anti-cancer effects that are independent of its anti-inflammatory effects and thus is a heavily researched molecule for both cancer prevention and treatment.
Other areas of interest as it pertains to curcumin are alleviating cognitive decline associated with aging, being heart healthy by both electrical means and reducing lipid and plaque levels in arteries, and both reducing the risk of diabetes and being a good treatment for the side-effects associated with diabetes.
It has a poor oral bioavailability (a low percentage of what you consume is absorbed) and thus should be enhanced with other agents such as black pepper extract, called piperine. This is unless you want the curcumin in your colon (as it is a colon anti-inflammatory and can help with digestion), in which case you wouldn’t pair it with an enhancement.
Doses up to 8g curcuminoids in humans have been shown to not be associated with much adverse effects at all, and in vitro tests suggest curcumin has quite a large safety threshold.
Another study link if interested:
http://meetinglibrary.asco.org/content/105958-133
God bless.
Hi, Lainy,
I woke up and saw your message. I am sorry.
I think if your have been on it for six months of Humira, you should not have problems in general for Remicade. Both drugs have the same precautions and similar side effects (ie:about lower your immunity to fight against infection.)The dose is based on your weight in kg.; so if you lost or gain substantial weight, the dose may be different between5-20mg/dose.Most of the time ,they may just keep the same dose(usual dose is 5mg/kg/dose). It is mixed with 250ml of IV solution and will run it over 2 hours;make sure they provide you an inline filter as recommended by the manufacturer to filter the drug particles while the IV is running. And mostly as you know, they will draw your blood and run the lab work before given the Remicade. Good luck on the colonoscopy and God bless you,my friend.
Hi,Renee,
“The best our Oncology Nurse Practitioner would comment was that some could not hurt, others were a waste of money…she bought them all anyway. “
This statement may be too general in answering questions related to chemotherapy especially the relatively new comer the “targeted agents therapy.”
Most of the patients by now should know not to take medications with grapefruit juice or with alcohol due to drug-food or drug -drug interaction in general.
But the targeted agents (TA)are relatively new and the side effects are still gathering data in Phase IV after market studies or from reports directly coming from the practice of oncologists who report the drug’s side effects which may not list on the package insert. and most of the “target agents” package inserts recommended not to use herbal or any diet supplements like St. John’s wart or even OTC medications,which is FDA approved like Zantac, Nexium and Pepcid etc. (do not take them together with TA)
When is in doubt,look it up ;sometimes most the medical professionals can give general information to answer general questions,but when it comes to your or my life, it is our lives and not theirs to pay more attention to research
or find out what is the proper and best interest to help medicated our self.
God bless.Hi, Renee,
I can honestly say to you, I really do not know any any reliable TCM practitioner myself here in the STATES, not to mention about how to get ” good quality product” of Chinese herbal medicine. I only know a few essential herbal products for herbal soups usage , beyond that , I bet most of us who came from the other side of the earth,the Far East may be except a few,do not really have a clue about the herbal products even if I bring my Chinese herbal bible with colorful pictures and “the how to select” section including technique such as size, touch,smell etc. In the good old days, you trust the name of the drug store( herbal shop) for the products they sold. Nowadays, when the New China liberated to become the second largest economy in the world, there are no more such association anymore.
Western medicine practice , in my opinion , is more scientific and based on more objective research on drugs and devices. Of course, do they , the medical professionals make unintentional mistakes, the answer is yes, because we all are human. Did some bad apples on the tree make other look poorly,absolutely.
But to give up and believe some other magical poison”can cure all” through advertisement like one of your friend you mentioned on another message is sad.
God bless.
